New citations - Practice Without Theory: A Philosophical Inquiry into Contemporary Nursing in South Asia

It is always welcome news when I learn of a paper (Asmat, 2024) recognising and citing Hodges' model from the nursing and wider literature. In this case an educational journal, focussed upon health and social care:

Kainat Asmat (2024). Practice Without Theory: A Philosophical Inquiry into Contemporary Nursing in South Asia: Nursing Practice without Theory. International Journal of Practice-based Learning in Health and Social Care. 12. 125-131. 10.18552/ijpblhsc.v12i2.1068. 

I have quoted at length, but it is good to have a different 'excuse' (not just extending the tail of a relevant book, or paper). ... 

'Similarly, Hodges' Health Career Model exemplifies its use as a tool for reflection during clinical assessments, care planning, and decision-making processes (Doyle & Jones, 2013). The model encourages nurses to reflect on their practice through multiple lenses, ensuring a comprehensive understanding of patient needs and care strategies. The Interpersonal domain emphasizes the relational aspects of nursing, including communication and empathy. The Sociological domain highlights the impact of societal factors and social determinants on health. The Scientific domain focuses on evidence-based practice and the integration of scientific knowledge into care. Finally, the Political domain addresses the influence of healthcare policies and organizational structures on contemporary nursing practice. In contemporary nursing practice, a nurse might use Hodges’ model to provide holistic and personalized care by considering the patient's social background, the scientific basis of their care, interpersonal dynamics, and relevant political or policy-related factors. According to Jones (2017), using conceptual models like Hodges' can greatly enhance nurses' critical thinking, fostering a reflective and engaged nursing workforce.' p.126.

'Collectively, nursing theory remains a cornerstone of contemporary nursing practice, providing an essential framework that guides clinical decision-making, promotes critical thinking, and supports reflective practice. Peter Jones, in his seminal works, underscores the critical role of theoretical models in enhancing nursing practice. His insights provide compelling evidence for the continued relevance of theory in contemporary practice. In "Humans, Information, and Science", Jones (1996a), articulates the interrelationship between human factors, informational processes, and scientific principles in healthcare. He argues that nursing, as a discipline, uniquely integrates these elements to form a comprehensive approach to patient care. This integration is fundamental in moving beyond task-oriented care towards a practice that is reflective and evidence-based. Jones emphasizes that without a theoretical foundation, contemporary nursing practice risks becoming fragmented and superficial, lacking the depth required for truly effective patient care. Similarly, in "An Overarching Theory of Health Communication",  Jones (1996b) explores the necessity of robust communication theories in healthcare. He posits that effective communication is not merely a skill but a complex process grounded in theoretical understanding. This perspective is particularly relevant to nursing, where communication is pivotal in patient interactions, interdisciplinary collaboration, and health education. Jones’ work illustrates that theoretical frameworks in communication enhance nurses' ability to engage with patients and colleagues thoughtfully and effectively, fostering better health outcomes and professional practice. Jones’ analyses reinforce the argument that nursing theory is indispensable in contemporary practice. Likewise, McEwen and Wills (2021) also highlight that nursing theory is integral to the development of nursing as a discipline. They assert that without the theoretical underpinnings, nursing risks regressing to a technical occupation devoid of critical thinking and judgment that characterize nursing professional practice. Thus, the survival and progression of nursing as a distinct profession depend on the continued integration and application of theory in contemporary nursing practice.' p.127.

In addition, the short conclusion is supportive and encouraging for ongoing efforts. As with all discovered citations thus far, I'm not sure of how Kainat Asmat located the publications on Hodges' model? A literature search - no doubt, or perhaps the blog's sidebar listing? The selection made, fits the author's purpose. 

Over the years, I've tried to indicate the scope and scale that Hodges' model can 'reach'. Especially in self-care, family, local, global and planetary health. Now, c/o Asmat (2024), Hodges' model has a much valued connection with South Asia. The required scope of Hodges' model (its inter- and transdisciplinary potential^) is also conceptual, referred to previously as holistic bandwidth. Hence the model's relevance and potential in theory and practice.

Many thanks to Kainat Asmat and the journal's editorial team.*

I will read again and return to the paper in our New Year.

Listed in the bibliography:

Doyle, M., Jones, P. (2013). Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing. 20, 7, 631-640.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2850.2012.01961.x/abstract

Jones, P. (1996a) Humans, Information, and Science, Journal of Advanced Nursing, 24(3),591-598. https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.1996.23321.x

Jones, P. (1996b) An overarching theory of health communication? Health Informatics Journal,2,1,28-34.

^Still on the agenda as a paper; as with 'revisiting' 1996a. Happy to support others in referencing, or writing more specifically about Hodges' model (a case study, mapping exercise?); especially student nurses, carers and personnel in social care and early career researchers. To which, I'd better add later career nurses, allied disciplines, nurses returning to practice (surely a UK and global policy focus?) and proof of reading (your choice of course on the paper, chapter, book...); and reflection for continuing professional development (CPD). If you're still unsure, it was a relief to put the 'pen' down, well writing is still a major challenge (and pain) here. 

*And, of course - Brian E. Hodges RIP - too.
https://hodges-model.blogspot.com/2023/08/brian-e-hodges-r-i-p.html

Just one library ... A world of difference

Born in Walton.

 'good prose is like a windowpane'

George Orwell, WHY I WRITE

<>

Walton, Liverpool, UK 12th December 2024

'Spellow Library, in Walton, Liverpool, was forced to close when it was set alight on 3 August amid unrest which swept across the country after the stabbings in Southport.

The city was determined to not let hatred win, with £250,000 raised and books being donated from the Queen and a host of celebrities.

An official ceremony marked the re-opening, including readings from Liverpool poet Levi Tafari while a letter from Queen Camilla was also read aloud.' ..

BBC News: Riot-hit library reopens after community campaign

Claire Hamilton/BBC: An official ceremony marked the re-opening on Thursday morning

Break the Windows on Learning and
New Ones Will be Found to Look Out on the World.

INDIVIDUAL

|

INTERPERSONAL : SCIENCES              

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

GROUP

My Learning My Literacies	'The World(s) of Learning'
Society - Community Social Justice	Justice Social/Public Services

Previously:

Related post: 'forms of Hygiene'

literature : window

Hornberger (1989) 'Continua of Biliteracy'. Review of Educational Research

The axes of Hodges' model present a problem in:

• theory
• practice
• evidence - research terms (data!).

The easiest to resolve is practice, which is were Hodges' model can lay claim to being a pragmatic solution. Of course, it isn't the axes that are the difficulty, it is the labels that Brian Hodges originally applied in the early-mid 1980's, followed by other users of the model since. From:

INDIVIDUAL <> GROUP - variations here in 'Welcome to the QUAD' [W2tQ] Patient <> Carer - Family : Client <> Health professional. You can progress to the "patient zero" and a population in an pandemic.

These are fundamental elements in clinical encounters, whether face-to-face, online, and across settings.

The same applies to the horizontal axis: HUMANISTIC <> MECHANISTIC.

As presented - in the sidebar, and the two-by-two table found in many posts - the model has a distinct dichotomous quality. It seems to set up, or invite opposition, or polarities. Sometimes I've viewed the axes as continua, but they are not graduated, incremental in a quantitative sense.

Do the axes of Hodges' model serve a need (do their work) by allowing the user to differentiate through opposition and relational appraisal (testing)? Perhaps, qualified in a respective profession / subject area, the user of Hodges' is employing other axes?

This brings us to intersectionality and the cognitive work of placing the person (couple, family, community ... biosphere) at the centre of our deliberations.

In biliteracy studies, Hornberger (1989) is perhaps more accurate in seeing a series of multidimensional and interrelated continua (p.273) which form a framework.

There are three figures in this paper and many other points of use:

"Contexts of biliteracy are defined, then, by these three continua. Any particular instance of biliteracy is located at a point of intersection among the three." p.280.

In health care this is readily understood given the varied contexts of the centre, the nexus of Hodges' model. When we say Hodges' model is situated, the centre of the model is the sweet and sour spot. For Hornberger, the context determines the use and significance of the continua.

This opens up Hodges' model as a potential tool to better understand the dimensions of diversity, inclusion and intersectionality.

Hornberger, N. H. (1989). Continua of Biliteracy. Review of Educational Research, 59(3), 271–296. https://doi.org/10.2307/1170183

No! This post hasn't been in draft since 1990. ;-)

NURSING -:- INFOTECH - worlds apart? Software testing

Another draft from over a decade ago ... duly revisited and updated:

https://www.statista.com/statistics/793628/worldwide-developer-survey-most-used-languages/

Reading up on Ruby and Rails and attending Scotland on Rails, I've been struck by the emphasis on testing. Testing in this context is about reliable software and building this into the 'product' from the outset. A book on Rails gets criticized because it leaves the chapter on 'Testing' until the end (even if the authors had their reasons - as they explained).

This take on testing is sufficient if (of course) it is appropriate and it is applied (as per the manual) to the application concerned. There are other more formal methods that extend to writing a specification for code which entails the use of formal specification languages such as Zed (as encountered in BA(Hons.) studies. This arises in situations were software is being developed for safety-critical situations. Clearly, robotic surgery, nuclear energy, and keeping an aircraft in the sky, take-off and landing are mission-critical. In the latter case a company is still dealing with life threatening loss of life that can follow, should the software system fail or more covertly introduce an error.

Reading about Rails, there are specific tests and these are provided as a result of scaffolding, a process whereby the bones of a web application are created within the Rails framework: with tests.

Rails creates a test directory for you as soon as you create a Rails project using bin/rails new application_name. If you list the contents of this directory then you will see:

$ ls -F test
application_system_test_case.rb  controllers/                     helpers/                         mailers/                         system/                          fixtures/                        integration/                     models/                          test_helper.rb

Source: https://guides.rubyonrails.org/testing.html

Rails uses a popular convention to organise and integrate the elements of a web application that includes a database, and dynamic interface. The approach is known as:

Models, Views and Controllers - MVC

MVC underpins several programming languages and frameworks. As displayed above, the tests that Rails creates have specific names and you can quickly see where they come from and how they encompass Rails (an essential property of course).

Today, I still wonder [ what's new! 😉 ] what is the equivalent to MVC in nursing? Models seems to fit! Over the years at many IT events, you can't help but reflect on nursing and its 'API' - application programming interface. Worryingly, in humanistic terms there is an instrumental potential in Hodges' model. If Nursing on Rails was a thing, what would the tests look like? Identity would be a feature, to demonstrate person-centredness, safety in medication and other treatment procedures. Is there a way to demonstrate the integration of care, and for a patient - the extent of holistic bandwidth? Of course, nursing comprises just a part of a clinical information system. It must be in sync in accord with other disciplines, medical and pharmacy and other multidisciplinary team members and yet ensure that 'nursing is visible'.

Previously: API : 'Waste not - want not'

Fragile: This way up - Frozen goods!

Apollo 17 'Blue Marble' Photograph

 

Apollo 17 1972 NASA Original Blue Marble Photograph

Or, some water 'heading your way' ...

'NASA’s archival designation for it is AS17-148-22727, and the original image was taken upside down with the South Pole at the top. In its myriad reproductions, it’s flipped up to match what we would normally expect to see.'

Text: https://www.thephoblographer.com/2013/12/09/behind-blue-marble/

Does the model still 'work' -

Group
|

 POLITICAL        :     SOCIOLOGY  

MECHANISTIC --------------------------------------  HUMANISTIC

            SCIENCES       :    INTERPERSONAL

|

Individual

POLITICAL	SOCIOLOGY
SCIENCES	INTERPERSONAL

- this way ...?

Image source: https://www.forum-conquete-spatiale.fr/t15428-apollo-17-1972

Prompt for 'Blue Marble' - Plate 1 in Brotton, J. (2024) The Four Points of the Compass: The Unexpected History of Direction, London: Allen Lane.

Previously: 'compass'

A planet is not just for Christmas.

Does the model still work - this way?

Does the model still 'work' -

Group
 |

 POLITICAL       :     SOCIOLOGY  

MECHANISTIC --------------------------------------  HUMANISTIC

          SCIENCES    :    INTERPERSONAL

| 

Individual

POLITICAL	SOCIOLOGY
SCIENCES	INTERPERSONAL

- this way ...?

The Science of Conceptual Systems - and Hodges' model

Wallis, S.E. The Science of Conceptual Systems: A Progress Report. Found Sci 21, 579–602 (2016). https://doi.org/10.1007/s10699-015-9425-z

From the conclusion:

'The approaches presented here do not provide a ‘‘map’’ for advancing the sciences. Indeed, none is available because we are advancing across that new terrain. What it does provide is a compass suggesting a new and potentially exciting direction to travel. Historically/traditionally, scholars have travelled about the countryside of the social/behavioral land making useful observations and gathering interesting data. They have often staked claims regarding the importance of their terrain. They could not advance more purposefully because they were guided only by intuition. So, they did not know what direction was ‘‘forward’’ although it seemed to have something to do with empirical analysis. Today, with the creation of a new science, we have a new direction.

When we do have a choice between theoretical maps, generally, and metaphorically, this paper suggests that we should choose to create and use roadmaps with many dots connected by many lines; not maps with few disconnected dots.' p.594.

There is also a glossary [pp.594-599] that includes:

'Integral thinking

Understanding (or attempting to understand) the world from a transdisciplinary perspective where those many perspectives are interrelated'

'Integrative propositional analysis (IPA)

Combined processes of qualitative and quantitative analysis involving rigorous hermeneutic deconstruction of propositions found in formal texts including the rigorous reintegration of propositions from those texts following a structured methodology. Also a process of meta-analysis for investigating conceptual systems to determine the Complexity of conceptual systems (diversity of concepts) and the Systemicity of the conceptual system (connectedness between concepts)'

'Mental model 

A representation within one’s mind about how the world works. Useful for understanding and engaging the world and for making predictions'

'Parsimony 

Generally, the understanding that a theory is better when it is smaller. Or, as small as possible while including ideas that are necessary or useful. Ockham’s Razor is a common example'

INDIVIDUAL

|

INTERPERSONAL : SCIENCES              

humanistic ---------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

GROUP

more SUBJECTIVE	more OBJECTIVE
QUALITY	QUANTITY

'Reflexive dimensional analysis (RDA) 

A process for creating a unified conceptual system from multiple conceptual systems through a process of categorization, abstraction, dimensionalization, and the identification of causal connections'

'Theory 

An ordered set of assertions. Weick (1989, p. 517. Drawing on Southerland)'

Cited above: 

Weick, K. E. (1989). Theory construction as disciplined imagination. Academy of Management Review, 14(4), 516–531.

Previously:

terrain : landscape : line-of-sight (with overlap; of interest in itself)

COVID-19: a Stamp of protection

INDIVIDUAL

|

INTERPERSONAL : SCIENCES              

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

GROUP

	Austria - Embroidered COVID-19 mask - Mint souvenir sheet

Source: Nordfrim.com - https://www.nordfrim.com/austria-covid-19-maske?

.. with apologies for the reminder!

forms of Hygiene

A gift for Hodges' model:

 'good prose is like a windowpane'

George Orwell, WHY I WRITE

https://www.ft.com/content/83625fad-f101-4712-ba2b-483b87ef0e12

'How is it that Orwell has become the single answer to so many questions, in so many different subjects, for so many people? His name conjures an amorphous idea of fair play and “common sense”; his spare prose supposedly brings cool nonpartisanship to a world of impassioned blusterers. In keeping your sentences clean, the theory goes, you practise intellectual hygiene (“good prose is like a windowpane” and all that). A single word, “Orwellian”, evokes the great man’s foresight about the dangers of an overweening nanny state, a censorious far-left or whatever else may be getting your goat that day.'

Naoise Dolan, Why weak thinkers love Orwell, FT Weekend Magazine, October 19/20, 2024, pp.16-18.

INDIVIDUAL

|

INTERPERSONAL : SCIENCES              

humanistic ------------------------------- mechanistic

SOCIOLOGY : POLITICAL   

|

GROUP

INTELLECTUAL MENTAL - EMOTIONAL - SPIRITUAL (Coping with the 21st Century) SELF-LIFE SKILLS (control anxiety - being organised) Health Literacy: Knowledge and aptitude for forms of HYGIENE	PERSONAL ENVIRONMENTAL DOMESTIC FOOD HANDS (How to sneeze, cough) ORAL - DENTAL CLOTHES BODY HAIR (frequency?) Sustainability - balance
SOCIAL COMMUNITY/RACIAL HYGIENE Insertion of memory lest we forget Insertion of a hook to do - think as we tolerance for x,y,z	POLITICAL HYGIENE aka. The Paradox To Vote : To be counted CIVIC

 

Reflecting about this in some contexts, more than others(?) I'm struck by the overlap between hygiene and literacy.

Completing, or attending to, being motivated to undertake - complete hygiene duties depends on knowledge and ability to act. Having basic needs met.

'

'Opening windows always ...'

literature : window

Reith Lectures: Gwen Adshead - 4 Questions about Violence

Individual
   |

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :   POLITICAL 

|

Group

Is there such a thing as Evil?	What is the relationship between trauma and violence?
Is violence normal^?	Can we change violent minds?

BBC Radio 4: Lecture 1 - Is there such a thing as Evil?

^'normal' -isation.